High resolution mapping of reticulated water fluoride in Western Australia: opportunities to improve oral health

Abstract

Background: Drinking water with an optimum fluoride concentration is a recognized effective method to reduce dental decay. Methods: In this study normal suppliers of drinking water in Western Australia provided map data regarding the distribution of their supplies and the locations of their test points. These data were collated into a single unified map of Western Australian water supplies and fluoride levels. It is clear that the effect of prevention in regionally isolated communities is significant as the cost of providing service is anywhere between 2 and 4 times higher than that in high density regions. Results: The current study found that although a very significant proportion of the population has access to water with fluoride concentrations that would be caries protective, most of these are large urban centre based. Conclusions: Those with high burdens of dental disease are mostly residential in rural and remote areas where water is either not fluoridated, nor regulated, or low in fluoride. However, it is acknowledged that water fluoridation, for many reasons, is not always feasible in rural and remote communities, and preventive efforts through alternative sources of fluoride (e.g. toothpaste) should be considered, even if less effective at community level.

Western Australian schools access to dentally optimal fluoridated water

“…Water supplies in WA are divided into two broad categories: regulated and non‐regulated water supplies . There are four main regulated water suppliers, namely: the Water Corporation; AqWest; Remote Aboriginal Essential Services; and Busselton Water . Water Corporation is the principal water supplier in WA .…”

“…Three other organizations are responsible for supplying water to less than 10% of the WA population. Data from these small suppliers were extracted from previously published studies . Past studies have shown that in WA there are a total of 286 identified Indigenous communities and the majority reside in remote areas.…”

“…the addition of fluoride to water with low fluoride levels, or reduce the levels of fluoride in water), to maintain healthy water supplies at optimally fluoridated levels . It is an effective, efficient, safe, socially equitable and cost‐effective public health method to prevent dental caries . In Australia, the individual state government water department looks after community water fluoridation.…”

“…In Western Australia (WA) water fluoride control is regulated by the Fluoridation of Public Water Supplies Act 1966 (water fluoride control involves adjusting the fluoride levels in water to optimal fluoride levels; it depends on a number of factors such as average daily water consumption and average temperature of the given area). It has been in place since the mid 1960s and water throughout the state is monitored continuously as part of a wider water monitoring regime . Notwithstanding this, there are areas in WA where the levels of fluoride do not meet the recommended dental health levels .…”

“…It has been in place since the mid 1960s and water throughout the state is monitored continuously as part of a wider water monitoring regime . Notwithstanding this, there are areas in WA where the levels of fluoride do not meet the recommended dental health levels . Most of these areas are remote and rural, and it is known that people in these communities suffer greater burdens of dental disease …”